Aftercare: Sustaining the Benefits of Containment

1. Aftercare: Sustaining the Benefits of Containment Caprice Haverty, PhDAlex Schmidt, MA A Step Forward (ASF) CCOSO Conference May 8, 2013

2. Quickwrite your responses to the following: 1.When you think of aftercare, what words come to mind? 2. What kind of support do your offenders have at the end of treatment and supervision?

3. What does “aftercare”mean? • After prison or jail or civil commitment? • After probation or parole? • After treatment? • After containment?

4. Community of Resource and Reunification (CORR) CORR is an aftercare (post containment) program which asks for a lifetime commitment on the part of treated sex offenders to open, ongoing accountability and continued involvement with treatment providers, peers (other treated sex offenders), family, friends, and the community. • Our contact is ongoing. • Our meetings are drop-in, voluntary, and free of charge.

5. CORR Logistics • Meets second Thursday of every month • Two therapists present • Began December 2008 • 30 men are committed to CORR; 10 more scheduled to begin in 2013 • Never fewer than 6 men present at meetings and have had up to 20

6. Social Support Team • Moves with the offender beyond treatment • Comprised of informed family and friends • Receives training from containment team • Approved by treating therapists • Familiarity with offender’s Safety Plan • Supported by ATSA and CCOSO guidelines

7. The Downside: • Support persons are not viable for the long-term: • •Training and Education •  few resources • •Long-term commitments •  little interest

8. ATSA Guidelines as they relate to support persons • ATSA members (treatment providers) encourage sex offenders to identify appropriate, pro-social individuals who can act as support persons • Therapists encourage support persons to actively participate in the treatment process and address issues related to risk (ATSA, 2005)

9. ATSA Position: Support Persons • Can include family members, church officials, employers, probation or parole officers, and treatment professionals • Know the client and can help him live successfully in the community • Can help clients cope with risky situations and help monitor their compliance with treatment or community supervision requirements • Help clients refrain from re-offending while they are living in the community (ATSA, 2005)

10. ATSA also says: Social Support Networks or Risk Management Teams Increase effectiveness of risk management strategies by monitoring: • Self-regulation • Pro-social behavior • Meaningful participation in treatment • Communication with offender and his greater network (ATSA, 2005)

11. CCOSO Guidelines as they relate to “Community Support” • recommend the use of: • Support Persons • Chaperones • Circles of Support and Accountability (COSA) • (Flinton et al, 2010)

12. Chaperones • Are individuals not teams • Are comprised of a family member or community support person • Can be trained by the containment team • Can be considered part of the containment team • Provide support and structure to an offender in the community (Flinton et al, 2010)

13. Circles of Support and Accountability (COSA) • 4-6 trained volunteers from the client’s community • At least one treatment professional heads the team • Supports the offender as part of reentry following prison • Regular meetings with the offender for a minimum of one year • Exerts positive social influence • Helps the ASO with cognitive and other problem-solving • Counteracts the social isolation, loneliness, and rejection associated with sexual reoffending • Their motto: “No more victims” (Wilson, Picheca & Prinzo, 2005) (Wilson, Cortoni & McWhinnie, 2007) (Wilson, Cortoni & McWhinnie, 2009)

14. Has COSA been successful? A variety of studies and their replications have found: • In Canada, 83% reduction in sexual reoffenses for 35 months (Wilson et al, 2009) • In UK, 61% reduction in sexual reoffenses over 3.5 years (Eliot & Beech, 2012) • In state of Minnesota, 3 out of 5 recidivism measures were shown to be “significantly reduced” over 3 years (no new arrests) (Duwe, 2013)

15. COSA Focus • Offender accountability • COSA Target • Cognitive distortions • COSA Encourage • The offender’s need to maintain a balanced, • self-determined lifestyle fully in line with risk/need • elements of effective intervention • (Andrews & Bonta, 2007) • as well as Good Lives Model • (Ward, 2002; Ward & Stewart, 2003; Wilson & Yates, 2009)

16. COSA STUDIES SHOW ADDITIONAL REDUCED RECIDIVISM IN BOTH VIOLENT AND GENERAL OFFENDING: • In Canada, 73% reduction in violent reoffending and 72% reduction in general offending over 35 months (Wilson et al. 2009) • In UK, 50% reduction in ALL reoffenses over 3.75 years (Eliot & Beech. 2012)

17. Offenders, community participants, public, & agency professionals were surveyed in the original study • 90% of offenders said that in the absence of COSA they would have had difficulties adjusting to the community and 2/3 felt they likely would have returned to crime without COSA • COSA became “surrogate families” and a “way of life” for many offenders • Offenders (83% of those surveyed) said they volunteered for COSA because they did not have other forms of social support • Offenders (2/3 of those surveyed) said they would try anything that would help them with reintegration into the community • 93% of Circle Volunteers felt the COSA was at least moderately helpful for the offender • 89% of Circle Volunteers felt the community experienced an increase in safety • 68% of Public Respondents said they would feel safer knowing a high-risk sexual offender in their community belonged to a COSA (Wilson et al, 2005)

18. COSA: Reported Difficulties and Challenges • Recruitment of volunteers and professionals (Wilson et al, 2005) (Duwe, 2013) • Financial stability (only part-time project coordinators and facilitators are paid) (Wilson et al, 2005)

19. Research shows the risk factors related to recidivism as well as the components of effective treatment for offenders: • Negative social influences • Rejection and loneliness • Lack of concern for others • Lack of cooperation with supervision • Impulsivity • Poor cognition problem solving (Hanson, Harris, Scott & Helmus, 2007) (Thornton, 2002)

20. Making a Case for Lifetime Aftercare • Following containment • Facilitated by trained individuals • Sex offenders encouraged to meet with each other for life

21. What We Know About Managing Recidivism • Sexual recidivism is decreasing as a result of jail, prison, supervision, treatment, monitoring devices, and community support. • COSA are showing good results. • Let’s do more: eliminate sexual recidivism.

22. Research shows the risk factors related to recidivism as well as the components of effective treatment for offenders: • Negative social influences • Rejection and loneliness • Lack of concern for others • Lack of cooperation with supervision • Impulsivity • Poor cognition problem solving (Hanson et al, 2007) (Thornton, 2002)

23. CORR: What It’s Not • It’s not a small social support network or risk management team • It’s not chaperones • It’s not COSA

24. Why It’s UniqueHow CORR Differs From COSA/Chaperones/Social Support Network/Risk Management or Support Team • Moderated by trained sex offender therapists • Encourages proactive, structured contact among treated offenders • Lifelong commitment • Long term accountability • Has wider circles of contact including their own and each other’s social support networks • Supports building healthy attachment-bonded relationships • Supports continued exploration of cognitive distortions, deviant arousal, etc. • Has potential for wide-range community involvement • Potential for wider range contact with victim advocates and/or victims • Supports community building

25. A Step Forward’sSex Offender Population • Probation, parole, or self-referred • Pre and Post-adjudication • Functioning and intelligence range low to high • Alcoholism • Substance and/or behavioral addiction • Impulse problems • Relational and/or intimacy deficits • Depression and anxiety • Tendency to isolate • Childhood trauma • Personality disorders • Mental illness • All types of sex crimes and levels of risk, from impulsive/opportunistic offenders to paraphilic and pedophilic

26. Eligibility For CORR • Nearing treatment completion • By invitation or recommendation • Articulate about level and types of arousal and risk • Passed polygraph • Supervision compliant • Accountable • Demonstrates development, insight, and understanding • Knows personal dynamic and/or static risk variables • Understands paraphilia • Has completed autobiography • Demonstrates authentic empathy • Connects to peers • Expresses buy-in to ongoing support

27. CORR: STRUCTURE • Communication between meetings: Yahoo discussion group: postings • Group texting • Potluck dinner and social: 30 min • Check-in • Create agenda in order of priority • Issue-focused up to 2 hours • Accountability to structure of group • Adherence to group agreements • Deep exploration, no superficiality • Accountability to zero tolerance for relapse

28. CORR GOALS: • CORR is a natural outgrowth of the various interventions and their impacts and, like treatment, is supportive-not punitive, hopeful-not pessimistic. • The men join CORR before they are terminated from formal supervision (probation or parole) and treatment. It is designed as something they maintain AFTER treatment and supervision end. • CORR increases public safety through its continued attention to risk management but also through public education. CORR seeks to make the public aware of its presence through inclusion, awareness, and education.

29. CORR honors what each man brings No matter how deviant, paraphilic, or character disordered: the need to develop boundaries and act in the world with integrity.

30. Current CORR Group Demographics • Members: 30 • Risk levels: 13 low; 11 high; 6 moderate. • Types: 4 incest offenders; 4 voyeurs; 4 exhibitionists; 2 Internet stalkers; 6 pedophiles; 6 child molesters; 4 sexual battery convictions. • Ethnicity: 2 Polynesian; 3 Black; 3 Hispanic; 22 White. • Ages: 22 to 70 • Age cluster/average: around 40.

31. WHY A LIFETIME COMMITMENT? Originally…for my own peace of mind

32. Sex Offenders Agreeing to Lifetime Contact? Yes! So much so, we started a program Individual Contracts Stepping Up  CORR

33. A lifetime commitment?!

34. WHY A LIFETIME COMMITMENT? • For the men • For their family and friends • For their communities • For their victims • For the public

35. CORR is a natural outgrowth of supervision and treatment • They become committed to one another. • They find they need each other. • They feel understood, accepted, and safe. • Intimacy evolves.

36. Treatment and Supervision Interventions During Containment Support CORR • Begin early in treatment • Use interventions that move them in the desired direction

37. Treatment Models Utilized • Relapse Prevention/CBT • Self-Regulation • Risk-Needs-Responsivity • GLM • Psychodynamic Theory/ Depth psychology • Attachment Theory

38. Relapse Prevention/CBT • Builds a cognitive self-reflective practice and tools • Increases self-regulation and mindfulness

39. Risk-Needs-Responsivity • What are their individual risk levels? • What are their dynamic risk factors/ criminogenic needs? • What are the best interventions to address and treat their risks and needs?

40. Self-Regulation Model • Incorporates cues from both internal emotional state and from environment; promotes awareness • Goal-oriented: focused on accomplishment of specific behavioral and experiential goals over time • Includes process model: how to identify goals, implement change, review progress and challenges, modify as necessary. • Not focused only on suppression/extinguishing of “bad” behavior; includes improvement of emotional experiences and overall quality of life • Emphasizes both approach goals (positive internal or external changes) versus avoidance goals (undesirable or harmful behaviors or emotional states)

41. Good Lives Model (GLM) • Increased self-efficacy and self-esteem • Positive, proactive, goal-directed behavior • Increased motivation • ASF Vision-Mapping

42. Psychodynamic Theory/Depth Psychology • Educational, social, family, and personal/childhood (trauma) history • Making the unknown and unconscious conscious • Deep self analysis and reflection • Self empathy leads to victim empathy

43. Attachment Theory • Early secure bonding leads to greater capacity for success, intimacy, and self regulation • Poor early bonding has been associated with poor self-regulation, impulse control problems, low self confidence, later sexual offending, and deficits in social skills and empathy. (Craissati, McClurg, & Browne, 2002) (Starzyk & Marshall, 2003) (Smallbone & Dadds, 1998)

44. All this creates...motivation for aftercare • Long-term ‘buy in’ • Deep commitment to each other • An ongoing, relapse-free lifestyle

45. Developing Motivation for Aftercare • With a respectful approach • Early in the treatment process • With a combination of treatment interventions • When we say, “We are here now and in the future.” And then they take action on their own behalf!

46. In Darin’s own words…

47. Treated Sex Offenders Need Support Beyond ContainmentMany are challenged by the following: • Registration • GPS monitoring • Homelessness • Limited employment • Financial stress • Public fear and scrutiny • Loss of family, friends, community • Ongoing conflict with family and friends • Discomfort • Deviant Arousal

48. Following treatment and supervision, what do offenders need? • A structured, formal, professional place to be with each other • A place to focus on the topic of their offending and its ongoing meaning and consequences • Support in holding each other to higher ethical and behavioral standards • Support to put into practice the skills they have learned in treatment and supervision

49. RED FLAG? Combining Low and High Risk Sexual Offenders

50. In Dean’s own words…